Last Thursday San Francisco’s chief medical examiner released the city’s updated overdose death count — 752 so far — making 2023 the worst year on record for drug-related fatalities. One-third of those people were listed as having no fixed address. Later that day, a crowd gathered at Civic Center Plaza to remember more than 420 who died in the city while experiencing homelessness this year.
Experts in overdose prevention say many teen and adult lives could be saved if more people know how to identify and respond to overdoses. In San Francisco, an array of programs are providing overdose response training to teenagers, college and medical-school students, and residents in neighborhoods that have a high rate of overdose deaths.
Several weeks after a crucial legal hurdle blocking safe consumption sites in San Francisco was seemingly resolved, proponents said they were dismayed that city leaders and public health officials were still not greenlighting centers that could reduce deaths related to drug use.
Overdose deaths have reached 620 this year — on track to have the highest annual tally since counting began, with fentanyl causing the vast majority of fatalities, according to the chief medical examiner’s latest report.
San Francisco District Attorney Brooke Jenkins has criticized and diminished the use of diversion programs that offer criminal defendants accused of selling drugs rehabilitation, counseling and training rather than jail sentences.
Since taking office 15 months ago, Jenkins has reduced the number of referrals to the San Francisco Pretrial Diversion Project by 70%, according to its CEO David Mauroff.
And as San Francisco’s rate of overdose fatalities reaches more than two deaths a day, Jenkins is pushing for defendants accused of selling drugs to remain in jail. But some legal experts say that’s a bad strategy both for the defendants and for public safety.
A drug crackdown in the Tenderloin and South of Market has resulted in more than 600 arrests, with authorities seizing more than 200 pounds of fentanyl since the initiative launched in May, Mayor London Breed said.
But the coordinated effort, involving city and state law enforcement agents, appears to be leading to violent clashes, said Supervisor Dean Preston, whose district includes the Tenderloin. “They’re poking a hornet’s nest,” he said in an interview.
Sarah Evans has spent decades advancing drug overdose prevention initiatives around the world. As a division director for Open Society Foundations — a grantmaking network founded and chaired by business magnate George Soros — Evans promotes one surefire way to help abate San Francisco’s homelessness and fatal overdose crisis: housing.
“The way that people get off the street is by getting into housing, where people can get support and stay there even while they are continuing to struggle with substance use disorders of all kinds and mental health issues,” said Evans, who leads the organization’s drug policy programs globally. “It literally is the only way.”
San Francisco isn’t doing enough to meet this housing need, according to health experts.
As San Francisco continues to search for solutions, our team at “Civic” is exploring the origins of the city’s opioid overdose crisis, what has been done to help and what might be making things worse. After six months of research involving hundreds of studies, reports and archival news clippings, and three dozen interviews with people with lived experience and professional expertise in homelessness, addiction, medicine, criminal justice, housing, social work, street outreach, business, education, harm reduction, policymaking and advocacy, we’re launching the series, “San Francisco and the Overdose Crisis.”
Over six episodes, the series will explore what influenced rampant opioid addiction and its connection to homelessness, the 150-year history of policing and prosecuting drugs in San Francisco, the long battle to open a safe consumption site in the city, and grassroots efforts to stem the tide of drug-related fatalities.
Supervisor Matt Dorsey received backlash this month for asking the mayor to redirect the entire $18.9 million in city funding budgeted for a new drop-in addiction treatment center toward jails instead.
Dorsey told the San Francisco Public Press that he reversed his previous support for the centers — called wellness hubs — once the city’s plans narrowed to one site from six, and removed safe consumption sites, which would have allowed people to consume drugs under supervision so they could receive immediate help in case of overdose.
Dorsey said he now wants the funds to go toward jail health services, including forcing treatment for people in jail who are struggling with substance abuse disorder.
Accidental drug overdose deaths continue to torment San Francisco, according to data released Tuesday by the city medical examiner’s office.
While June saw the lowest monthly number of overdose deaths this year, 54, in July it climbed back up to 71. With 473 overdose deaths this year, San Francisco is on track to surpass its highest recorded number of overdose deaths in a calendar year — 725 in 2020.
Last week’s deployment of the National Guard and California Highway Patrol onto San Francisco’s streets to crack down on drugs comes amid intense public pressure to address open air drug use and sales.
But the emphasis on law enforcement for addressing the city’s drug crisis has distressed public defense attorneys and harm reduction advocates who fear the move may worsen the rate of fatal overdoses.